| NPI | 1215196373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY GREEN Billing Department 314-878-0163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 38383) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2008-06-04 |